Archive for the ‘Family Health Insurance’ Category

Not only is it a big weekend for March Madness basketball, it’s a big weekend for the health insurance industry as well. March 31 is the deadline to sign up for health insurance or else risk receiving a penalty by the government when you file your taxes next year. As long as you have started filling out a health insurance application, there is a grace period until April 7 to finish filing your paperwork. The Associated Press offered important information in their article, “Monday is the deadline to sign up for health law”. Government reports say that more than 6 million people have already signed up for health insurance through the newly created marketplaces since they opened October 1. That number doesn’t even take into account the number of people who have signed up for new health insurance plans outside of the marketplaces since the new law took effect. Four out of five of the people signing up in the marketplace have gotten a government tax credit to help pay for their premium cost.

The federal government’s website has a deadline of midnight on March 31, but states that are running their own marketplaces might have different deadlines in place. You can sign up online, by phone, or even in person because many local areas have sign-up centers. Since we are down to the wire with sign-up time, there will probably be long wait times no matter which way to choose to sign up through Monday. If you don’t qualify for a government tax subsidy, but want to get health insurance to follow the law, there are many more options for finding health insurance. You can compare health rates for individual or family insurance plans here.

In Tennessee, there is a “Local push underway to get health insurance before (the) deadline“. Local ABC News affiliate WATE reporter Kayla Strayer posted a list of locations where people in East Tennessee can receive free help from insurance agents. One out of six people in Tennessee has been living without health insurance. Most of these people say that they simply can’t afford it. Insurance experts are helping many of these Tennesseans determine whether they qualify for government subsidies as well as helping them with the application process. One volunteer says that you can see the relief on people’s faces when they find a health insurance plan that they can afford. Many have been going without health insurance, and in turn doctor visits and tests, even though they know they need treatment. Americans have to sign up for health insurance by March 31, or risk being charged a fee. Fees are equal to 1% of your income, or $95 per adult and $50 per child. Some Americans will be exempt from this insurance mandate.

The country has been very focused on uninsured Americans over the past couple of years. Another important issue that is rarely discussed is how many people are actually underinsured. U.S. News & World Report’s Kimberly Leonard discussed research from the Commonwealth Fund in her article, “Report Highlights Underinsured by State”. The Commonwealth Fund’s report is called “America’s Underinsured: A State-by-State Look at Health Insurance Affordability Prior to the New Coverage Expansions”. When looking at Americans under the age of 65, one out of every eight is underinsured. This means that although they do have health insurance, they still pay a high percentage out of pocket for health care costs. Many underinsured Americans end up filing for bankruptcy because of their health care bills. They are also at a high risk of ignoring symptoms and avoiding the doctor.

States with the lowest rates of underinsured Americans were in the Northeast and the upper Midwest. The Southern and Western states had the highest rates. New Hampshire’s underinsured rate of 8% was the lowest in the nation. Some of the other states with low rates include Minnesota, Maryland, and Massachusetts. The highest underinsured rate of 17% belongs to both Idaho and Utah. Both Tennessee and Mississippi had underinsured rates of 16%. When the report looked at the combination of uninsured and underinsured Americans, the highest numbers of uninsured and underinsured Americans were in New Mexico and Texas. Middle income Americans in Wyoming and Alaska suffer the most from being uninsured or underinsured. One-third of the middle income population in those states falls into the uninsured or underinsured category. The lowest uninsured and underinsured rates were in Connecticut, Massachusetts, Minnesota, and the District of Columbia. These states had combined rates less than 20%.

Deductibles, premiums, household income, and insurance status were taken into account for the report results. Lower income households, earning less than $47,000 per year for a family of four, are considered underinsured if they spend more than 5% of their yearly income on health care costs. Middle income households, earning between $47,000 and $95,000 per year, are underinsured if more than 10% of their annual income is spent on health care. The Commonwealth Fund report found that $32 million Americans are underinsured, $4 million of whom come from middle income families. It also showed that 47 million Americans were uninsured in 2012. Obviously this data was collected before the Affordable Care Act went into effect. It will be a good comparison for the next few years to see if the ACA makes the changes that it set out to make in “fixing” our health care system. The number of uninsured Americans has certainly gone down, and the number of underinsured Americans should as well. Since insurance companies can no longer discriminate against those with preexisting conditions and they must offer affordable plan choices, fewer Americans may be underinsured in the future.

There is some great news for Americans struggling with mental health or addiction who were having problems with their insurance coverage. Insurance plans offered in the federal and state run health insurance exchanges are required to offer coverage for mental health care and addiction treatment under the 10 essential benefit requirements. This information comes from The New York Times article “Understanding New Rules That Widen Mental Health Coverage,” by Ann Carrns. This coverage expansion is welcome news to millions of Americans who have been suffering with seemingly no hope for help. Whether they couldn’t find an insurance plan that offered mental health coverage or the benefits were not the same as medical coverage, they will now have help.

Inclusion in the 10 essential health benefits is not the only change affecting mental health and addiction treatment. Back in 2008, the Mental Health Parity and Addiction Equity Act worked to make mental health coverage the same as coverage for physical health ailments. While they have had a long road, parity rules will finally take effect in July of this year. Most health insurance companies will have to follow these rules in their individual and family insurance plans starting next January. When insurance companies offer mental health coverage, they will not be able to charge higher deductibles or co-pays for these visits than they do for medical visits. They also cannot limit the number of mental health visits allowed in a more restrictive way than they do for medical visits.

Some insurance companies already follow the parity rules, but how they comply with them will now be detailed by the government. They can’t limit the geographical region for mental health coverage if they don’t limit it for medical coverage. Insurance companies cannot make it more difficult to get pre-approval for inpatient mental health treatments than they do for inpatient medical care. They also have to make it clear to consumers what criteria they are using to determine their ruling. This is good news for consumers who have been struggling to get mental health care because the insurance coverage was less adequate than their medical coverage.

It’s important to note, however, than it won’t necessarily be easier to get mental health treatment because of one big factor. Around half of psychiatrists do not accept private health insurance as payment, mostly because their reimbursement has been terrible in the past. Since these new rules are going in effect, it is possible that more office based psychiatrists will accept private insurance in the next few years. Be an advocate for yourself and make sure that you know the laws and rules that apply to mental health and addiction coverage. If you are having a hard time with your insurance company or can’t find a therapist who will accept your plan, there are free services to help you locate one.